Progress and prospect of TIPS for portal hypertension_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 MA Jun

Department of Interventional and Vascular Surgery, The People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan 750002, P. R. China;

Corresponding?author：

MA Jun, Email: 454782980@qq.com

Keywords：

portal hypertension; esophagogastric variceal bleeding; transjugular intrahepatic portosystemic shunt; progress

DOI：

10.7507/1007-9424.202207009

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Transjugular intrahepatic portosystemic shunt (TIPS) has been used in the treatment of cirrhotic portal hypertension for more than 30 years. With the development of stent technology and clinical practice technology, TIPS is becoming more and more perfect in the treatment of portal hypertension. From the single-use of bare stent in the past to the application of bare stent combined with coated stent or particular Viatorr stent, the patency of stent has been significantly improved. In addition, the selection of stent caliber and the puncture part of shunt gradually reduces the occurrence of hepatic encephalopathy, liver failure and other complications caused by excessive shunt. TIPS technology has the advantages of minimally invasive, safe and reducing portal vein pressure. It has gradually become one of the primary surgical methods in the treatment of portal hypertension, esophagogastric variceal bleeding, intractable ascites, and so on.

Citation： MA Jun. Progress and prospect of TIPS for portal hypertension. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(8): 997-1000. doi: 10.7507/1007-9424.202207009 Copy

1.	馬鹍鵬, 梁松年, 鐘紅珊, 等. Viatorr支架行TIPS術治療門靜脈高壓性靜脈曲張消化道出血效果評估. 介入放射學雜志, 2020, 29(4): 380-384.
2.	Richter GM, N?ldge G, Roeren T, et al. Historische und konzeptionelle Aspekte von TIPSS [Historical and conceptional aspects of TIPSS]. Radiologe, 1994, 34(4): 158-163.
3.	中國門靜脈高壓診斷與監測研究組(CHESS), 中華醫學會消化病學分會微創介入協作組, 中國醫師協會介入醫師分會急診介入專業委員會, 等. 中國肝靜脈壓力梯度臨床應用專家共識 (2018版). 中華消化外科雜志, 2018, 17(11): 1059-1070.
4.	Ueda C, Yosizaki T, Katayama N, et al. Barrett’s adenocarcinoma with esophageal varices successfully treated by endoscopic submucosal dissection with direct varices coagulation. Clin J Gastroenterol, 2020, 13(2): 178-181.
5.	Wang YM, Li YH, Wu HM, et al. Portal vein thrombosis in patients with cirrhosis undergoing elective transjugular intrahepatic portosystemic shunt: risk factors, warfarin efficacy, and clinical outcomes. Clin Appl Thromb Hemost, 2018, 24(3): 462-470.
6.	李偉, 宋衛東, 謝巴圖白音. 采用EVL或TIPS治療肝硬化并發食管靜脈曲張出血患者療效及其預后分析. 實用肝臟病雜志, 2021, 24(5): 629-632.
7.	趙洪偉, 齊瑞兆, 岳振東, 等. 3 367例經頸靜脈肝內門體分流術的技術難點分析. 中華消化外科雜志, 2016, 15(7): 689-695.
8.	Luo X, Wang Z, Tsauo J, et al. Advanced cirrhosis combined with portal vein thrombosis: A randomized trial of TIPS versus endoscopic band ligation plus propranolol for the prevention of recurrent esophageal variceal bleeding. Radiology, 2015, 276(1): 286-293.
9.	李瑩, 練晶晶, 羅添成, 等. 預防肝硬化食管靜脈曲張再出血的成本效果研究. 中華消化雜志, 2016, 36(2): 113-118.
10.	de Franchis R; Baveno VI Faculty. Expanding consensus in portal hypertension: Report of the Baveno Ⅵ Consensus Workshop: Stratifying risk and individualizing care for portal hypertension. J Hepatol, 2015, 63(3): 743-752.
11.	中國醫師協會介入醫師分會. 中國門靜脈高壓經頸靜脈肝內門體分流術臨床實踐指南 (2019版). 中華醫學雜志, 2019, 99(45): 3534-3546.
12.	中國醫師協會急診醫師分會, 中華醫學會急診醫學分會, 全軍急救醫學專業委員會, 等. 急性上消化道出血急診診治流程專家共識. 中國急救醫學, 2021, 41(1): 1-10.
13.	Garcia-Tsao G, Abraldes JG, Berzigotti A, et al. Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases. Hepatology, 2017, 65(1): 310-335.
14.	Li S, Zhang C, Lin LL, et al. Early-TIPS versus current standard therapy for acute variceal bleeding in cirrhosis patients: A systemic review with meta-analysis. Front Pharmacol, 2020, 11: 603. doi: 10.3389/fphar.2020.00603.
15.	劉劍, 謝勇, 魏翠, 等. 早期經頸靜脈肝內門體分流術治療肝硬化急性靜脈曲張破裂出血患者的meta分析. 介入放射學雜志, 2022, 31(1): 19-26.
16.	Violi F, Corazza GR, Caldwell SH, et al. Portal vein thrombosis relevance on liver cirrhosis: Italian Venous Thrombotic Events Registry. Intern Emerg Med, 2016, 11(8): 1059-1066.
17.	Khalili H, Goldman D, Frischhertz S, et al. Clinical images: transjugular intrahepatic portosystemic shunt reduction for management of recurrent hepatic encephalopathy. Ochsner J, 2017, 17(4): 311-316.
18.	Vilstrup H, Amodio P, Bajaj J, et al. Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology, 2014, 60(2): 715-735.
19.	褚建國, 孫曉麗, 樸龍松, 等. 門靜脈左支分流降低術后肝性腦病的臨床研究. 中華肝臟病雜志, 2002, 10(6): 437-440.
20.	Madoff DC, Wallace MJ. Reduced stents and stent-grafts for the management of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt creation. Semin Intervent Radiol, 2005, 22(4): 316-328.
21.	萬里, 張文廣, 任建莊, 等. 限流支架治療經頸靜脈肝內門體分流術后難治性肝性腦病效果和安全性分析. 介入放射學雜志, 2021, 30(7): 662-666.
22.	Kao SD, Morshedi MM, Narsinh KH, et al. Intravascular ultrasound in the creation of transhepatic portosystemic shunts reduces needle passes, radiation dose, and procedure time: A retrospective study of a single-institution experience. J Vasc Interv Radiol, 2016, 27(8): 1148-1153.
23.	Pillai AK, Andring B, Faulconer N, et al. Utility of intravascular US-guided portal vein access during transjugular intrahepatic portosystemic shunt creation: Retrospective comparison with conventional technique in 109 patients. J Vasc Interv Radiol, 2016, 27(8): 1154-1159.

1. 馬鹍鵬, 梁松年, 鐘紅珊, 等. Viatorr支架行TIPS術治療門靜脈高壓性靜脈曲張消化道出血效果評估. 介入放射學雜志, 2020, 29(4): 380-384.
2. Richter GM, N?ldge G, Roeren T, et al. Historische und konzeptionelle Aspekte von TIPSS [Historical and conceptional aspects of TIPSS]. Radiologe, 1994, 34(4): 158-163.
3. 中國門靜脈高壓診斷與監測研究組(CHESS), 中華醫學會消化病學分會微創介入協作組, 中國醫師協會介入醫師分會急診介入專業委員會, 等. 中國肝靜脈壓力梯度臨床應用專家共識 (2018版). 中華消化外科雜志, 2018, 17(11): 1059-1070.
4. Ueda C, Yosizaki T, Katayama N, et al. Barrett’s adenocarcinoma with esophageal varices successfully treated by endoscopic submucosal dissection with direct varices coagulation. Clin J Gastroenterol, 2020, 13(2): 178-181.
5. Wang YM, Li YH, Wu HM, et al. Portal vein thrombosis in patients with cirrhosis undergoing elective transjugular intrahepatic portosystemic shunt: risk factors, warfarin efficacy, and clinical outcomes. Clin Appl Thromb Hemost, 2018, 24(3): 462-470.
6. 李偉, 宋衛東, 謝巴圖白音. 采用EVL或TIPS治療肝硬化并發食管靜脈曲張出血患者療效及其預后分析. 實用肝臟病雜志, 2021, 24(5): 629-632.
7. 趙洪偉, 齊瑞兆, 岳振東, 等. 3 367例經頸靜脈肝內門體分流術的技術難點分析. 中華消化外科雜志, 2016, 15(7): 689-695.
8. Luo X, Wang Z, Tsauo J, et al. Advanced cirrhosis combined with portal vein thrombosis: A randomized trial of TIPS versus endoscopic band ligation plus propranolol for the prevention of recurrent esophageal variceal bleeding. Radiology, 2015, 276(1): 286-293.
9. 李瑩, 練晶晶, 羅添成, 等. 預防肝硬化食管靜脈曲張再出血的成本效果研究. 中華消化雜志, 2016, 36(2): 113-118.
10. de Franchis R; Baveno VI Faculty. Expanding consensus in portal hypertension: Report of the Baveno Ⅵ Consensus Workshop: Stratifying risk and individualizing care for portal hypertension. J Hepatol, 2015, 63(3): 743-752.
11. 中國醫師協會介入醫師分會. 中國門靜脈高壓經頸靜脈肝內門體分流術臨床實踐指南 (2019版). 中華醫學雜志, 2019, 99(45): 3534-3546.
12. 中國醫師協會急診醫師分會, 中華醫學會急診醫學分會, 全軍急救醫學專業委員會, 等. 急性上消化道出血急診診治流程專家共識. 中國急救醫學, 2021, 41(1): 1-10.
13. Garcia-Tsao G, Abraldes JG, Berzigotti A, et al. Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases. Hepatology, 2017, 65(1): 310-335.
14. Li S, Zhang C, Lin LL, et al. Early-TIPS versus current standard therapy for acute variceal bleeding in cirrhosis patients: A systemic review with meta-analysis. Front Pharmacol, 2020, 11: 603. doi: 10.3389/fphar.2020.00603.
15. 劉劍, 謝勇, 魏翠, 等. 早期經頸靜脈肝內門體分流術治療肝硬化急性靜脈曲張破裂出血患者的meta分析. 介入放射學雜志, 2022, 31(1): 19-26.
16. Violi F, Corazza GR, Caldwell SH, et al. Portal vein thrombosis relevance on liver cirrhosis: Italian Venous Thrombotic Events Registry. Intern Emerg Med, 2016, 11(8): 1059-1066.
17. Khalili H, Goldman D, Frischhertz S, et al. Clinical images: transjugular intrahepatic portosystemic shunt reduction for management of recurrent hepatic encephalopathy. Ochsner J, 2017, 17(4): 311-316.
18. Vilstrup H, Amodio P, Bajaj J, et al. Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology, 2014, 60(2): 715-735.
19. 褚建國, 孫曉麗, 樸龍松, 等. 門靜脈左支分流降低術后肝性腦病的臨床研究. 中華肝臟病雜志, 2002, 10(6): 437-440.
20. Madoff DC, Wallace MJ. Reduced stents and stent-grafts for the management of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt creation. Semin Intervent Radiol, 2005, 22(4): 316-328.
21. 萬里, 張文廣, 任建莊, 等. 限流支架治療經頸靜脈肝內門體分流術后難治性肝性腦病效果和安全性分析. 介入放射學雜志, 2021, 30(7): 662-666.
22. Kao SD, Morshedi MM, Narsinh KH, et al. Intravascular ultrasound in the creation of transhepatic portosystemic shunts reduces needle passes, radiation dose, and procedure time: A retrospective study of a single-institution experience. J Vasc Interv Radiol, 2016, 27(8): 1148-1153.
23. Pillai AK, Andring B, Faulconer N, et al. Utility of intravascular US-guided portal vein access during transjugular intrahepatic portosystemic shunt creation: Retrospective comparison with conventional technique in 109 patients. J Vasc Interv Radiol, 2016, 27(8): 1154-1159.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Progress and prospect of TIPS for portal hypertension

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